05D1106813 CLIA NUMBER - DIGNITY HEALTH MEDICAL FOUNDATION

Laboratory Demographics

CLIA Number: 05D1106813

Facility Name: DIGNITY HEALTH MEDICAL FOUNDATION

Facility Address:
9500 STOCKDALE HWY STE 203
BAKERSFIELD, CA
ZIP 93311
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Facility Phone Number: 916 379-2861

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1538731278

Taxonomy: 261QC1500X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D1106813
LAB Type	Physician Office
Facility Name	DIGNITY HEALTH MEDICAL FOUNDATION
Street	9500 STOCKDALE HWY STE 203
City	BAKERSFIELD
State	CA
ZIP	93311
Phone	916 379-2861
CertificateType	3
CertificateEffectiveDate	10/22/2023
CertificateExpirationDate	10/21/2025
FacilityType	PPMP

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This page was last updated on: 4/23/2024